曲马多对肺癌患者开胸手术围术期免疫功能的影响

Effect of tramadol on immune function in lung cancer patients

目的探讨曲马多术前应用对肺癌患者开胸手术围术期免疫功能的影响。方法择期行开胸手术的肺癌患者60例,随机均分为四组,分别在麻醉诱导后使用曲马多1mg/kg(T组)、恩丹西酮8mg(O组)、曲马多1mg/kg+恩丹西酮8mg(TO组),对照组(C组)不用药。于术前、术毕测定患者血清T淋巴细胞亚群(CD3+、CD4+、CD8+)及NK细胞百分比。结果四组术毕CD4+细胞显著减低,CD8+细胞显著增高(P<0.05)。T组术毕NK细胞显著增高(P<0.05),而其它三组明显降低(P<0.05)。结论肺癌患者使用曲马多更有利于免疫功能的恢复,主要表现为NK细胞百分比增高。

Objective To investigate the effect of tramadol on immune function in cancer patients undergoing conventional pulmonary lobectomy. Methods Sixty cancer patients undergoing conventional pulmonary lobectomy were randomly assigned to one of four groups （n= 15）. Group T received iv tramadol 1 mg/kg after induction. Group O received ondansetron 8 mg after induction. Group TO received iv tramadol 1 mg/kg and ondansetron 8 mg after induction. Group C was control group. Peripheral venous blood samples were collected before and at the end of surgery for the determination of CD3＋, CD4＋, CD8＋ and natural-killer cells. Results The CD4＋ and CD4＋/ CD8＋ decreased while CDS＋ increased after the operation （P〈0.05）. The number of NK cells after surgery was higher in group T （P〈0. 05） meanwhile the numbers of NK cells in other groups were significant lower （P〈0.05）. Conclusion Our results suggest that tramadol can maintain a higher NK ratio which has a positive effect on immune function in lung cancer patients.